Transplantation for Kidney Disease in Adults
Surgeons at NYU Langone’s Transplant Institute perform kidney transplantation for people who have been diagnosed with advanced kidney disease or kidney failure, in which the kidneys can no longer filter waste from the body.
In kidney transplantation, one kidney obtained from a donor is implanted into the pelvis to assume the function of the failed kidneys, which typically remain in the body. One healthy kidney can perform the work of two kidneys.
A kidney donor can be a healthy family member, friend, coworker, or anyone willing to provide a kidney. This is called living donation. Because the body can function with one kidney, donors can lead healthy, active lives after recovery from surgery.
Sometimes a kidney is provided by a cadaver donor, which means it’s from someone who had consented to donation or whose family gave consent. If a living donor is not available, our experts can help place you on a national kidney transplant waiting list.
With either type of donor, the donor’s blood type is determined to ensure it is compatible with the recipient’s blood type. The donor’s blood is also screened for conditions such as human immunodeficiency virus (HIV) and hepatitis. A 24-hour urine test, in which urine is collected throughout a full day and night, is used to check the donor’s kidney function. Imaging tests, such as X-ray, CT, or MRI, also help doctors assess the health of the donor’s kidneys.
Other tests, such as an electrocardiogram, which measures the heart’s electrical activity, are performed when donors are older than age 50 to make sure they’re strong enough for surgery. Donors who smoke have pulmonary testing to check their lungs.
Donors must meet with a social worker or psychologist for an evaluation before meeting the surgeon to discuss the transplantation process. NYU Langone’s transplant team meets to discuss the donor’s eligibility. Should the donor change his or her mind, the process is stopped.
Kidney Transplantation Surgery
During kidney transplantation surgery, the donor’s kidney is removed through a minimally invasive procedure that requires a small incision and general anesthesia. After the procedure, the donor remains in the hospital for two days for observation. Donors can usually return to light activities after two weeks and regular activities after six weeks.
Soon after the kidney is removed from the donor, it’s implanted into the transplant recipient’s body in a procedure that requires general anesthesia. During this surgery, an incision is made in the lower abdomen. The kidney is inserted and attached, using stitches, to the ureters, the tubes that connect the kidney to the bladder, and to the arteries that supply blood to the legs.
The incision is closed with stitches, and a drain may be placed at the incision site to remove fluid and reduce swelling. A bandage or dressing is placed over the area.
After surgery, you remain in the intensive care unit, so doctors can monitor your blood pressure, pulse, and breathing. When they’ve determined that your health is stable, you are moved to a hospital room for two to four days of recovery, during which a catheter may be inserted to drain urine from the bladder. Your doctor performs blood testing to monitor the donated kidney’s ability to function in your body.
You remain in the hospital for up to five days and return for frequent follow-up visits during the first three months after surgery.
You must take immunosuppressive medications, which help to prevent the body from rejecting the donated kidney, for the rest of your life.